Cost of Care Analyst

Location

This role requires associates to be in‑office 1–2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work‑life balance. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Cost of Care Analyst (Advanced Analytics Consultant) employs advanced analytics to gain critical insights into member behavior drivers and preferences, product/program concepts and value propositions, operational effectiveness, and efficiencies, and client‑specific health gaps and needs. The analyst consults business leaders and internal partners to apply the insights to test and drive product innovation and enhancement, target the right members for the right service, measure program outcomes and demonstrate value, help win and retain clients, and support information‑based strategic decision‑making.

• Provides analytical insights to support business solution development based on quality, use, cost, and other key drivers.
• Develops and refines analysis templates for problem diagnosis and opportunity assessment.
• Consults on all considerations related to designing and executing tests or pilot programs.
• Contributes to the design of new programs and initiatives based on test/pilot outcomes.
• Develops targeting criteria or customer segmentation based on analytical insights, clinical inputs, product design, and operations considerations.
• Develops predictive models and other tools to target the right members.
• Develops methodology to measure clinical, utilization, and financial outcomes of a program or initiative.
• Conducts in‑depth research to address challenging issues in measuring outcomes.
• Leads applied research projects.
• Authors white papers, presents at industry conferences, and submits journal publications.
• Addresses limitations of data sources and evaluates incremental value of new data sources.

• MS, MA, or PhD with concentration in a quantitative discipline such as Mathematics, Statistics, Economics, Epidemiology, Engineering, Computer Science, or Operations Research and a minimum of five years experience in related health care analytics; or an equivalent combination of education and experience.

• Experience performing trend analysis to identify patterns in healthcare costs over time, offering insights to optimize cost management strategies and improve financial outcomes.
• In‑depth understanding of healthcare dynamics, including service delivery, reimbursement models, and payer systems.
• Experience in healthcare finance or healthcare actuarial analytics.
• Substantial analytical experience in the healthcare industry.
• Advanced SQL and SAS skills.
• Oracle Exadata experience.
• Familiarity with AI/ML frameworks.
• Additional skills for success:
  Python, Informatica, Tableau, and/or Power BI.
• Experience using Agile estimation techniques such as Planning Poker, T‑shirt sizing, or the Fibonacci sequence to provide relative estimates related to Cost of Care.
• Ability to present meaningful results to a business audience, collaborate in a team to produce complex analyses on a rigorous schedule, and communicate with strong written and verbal skills.
• Comprehensive experience with Teradata, SQL, or an equivalent data database.

Elevance Health requires all new candidates in certain patient/member‑facing roles to be vaccinated against COVID‑19 and influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health follows all relevant federal, state, and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process may contact elevancehealthj for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.